| NPI | 1679554539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 042.0018986) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 043205) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2025-12-04 |