| NPI | 1407852452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX J5905) |
| Additional Taxonomies | 174400000X Specialist |
| 174400000X Specialist (Licence: TX J5905) | |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2025-10-01 |