| NPI | 1417960634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301072422) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 42387) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2025-09-23 |