| NPI | 1649615642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 009229) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 7071) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 7071) | |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2026-08-31 |