| NPI | 1578125100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL TRN29742) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 103108) |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2026-01-05 |