| NPI | 1710180724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD155959) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD155959) |
| 207R00000X Internal Medicine (Licence: MA 221905) | |
| 207R00000X Internal Medicine (Licence: WA MD6066764) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60667764) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2026-06-19 |