| NPI | 1437496197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2018011480) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3217) |
| 207R00000X Internal Medicine (Licence: MO 2018011480) | |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2026-04-14 |