| NPI | 1518595222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 76421) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 36894) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2026-07-02 |