| NPI | 1417268566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 110694) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME162872) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 110694) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2026-05-21 |