| NPI | 1528544525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: RI MD21030) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2020019302) |
| 207R00000X Internal Medicine (Licence: OH 35.147744) | |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2026-07-24 |