| NPI | 1376047506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME174647) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072239) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2025-08-06 |