| NPI | 1497749725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2026-00336) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 72205) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2026-03-12 |