| NPI | 1568524809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101241539) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD423299) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2026-09-19 |