| NPI | 1538691241 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 21953) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 21953) | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 14001256-1205) | |
| Enumeration Date | 2017-03-31 | 
| Last Update Date | 2025-03-10 |