| NPI | 1477057651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 11393260-8905) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101278629) |
| 207R00000X Internal Medicine (Licence: UT 11393260-1205) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101278629) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2025-07-18 |