| NPI | 1598327678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2026009701) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2026009701) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: MO 2026009701) | |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2026-06-22 |