| NPI | 1457889743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2023-01500) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: SC LL41091) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2025-08-26 |