| NPI | 1689103293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NV 27245) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04034) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0097514) | |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2025-05-29 |