| NPI | 1548218662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CO 34460) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA c174764) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2026-01-07 |