| NPI | 1700315686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME176413) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 27366) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2025-10-09 |