| NPI | 1457407702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A101827) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA a101827) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2026-03-10 |