| NPI | 1669812087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 24230) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-2714) |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2025-03-25 |