| NPI | 1457092181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2026-01795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 102404) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-04-07 |