| NPI | 1407380058 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101282250) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD500002820) | 
| 207R00000X Internal Medicine (Licence: VA 0101282250) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD500002820) | |
| Enumeration Date | 2017-04-19 | 
| Last Update Date | 2025-07-03 |