| NPI | 1619147915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 42491) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A129186) |
| 207R00000X Internal Medicine (Licence: NY 247585) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 74428) | |
| 207R00000X Internal Medicine (Licence: TN 74428) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35C.002950) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2025-10-21 |