| NPI | 1700875747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2021032641) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 87420) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.065182) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01044094) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2025-06-04 |