| NPI | 1437619350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 1015406) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 292423) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-06-09 |