| NPI | 1598706244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL LL951) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD15290) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2026-08-05 |