| NPI | 1548618796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301069000) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME 77577) |
| Enumeration Date | 2016-05-28 |
| Last Update Date | 2026-01-09 |