| NPI | 1710417217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 271866) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD489697) |
| Enumeration Date | 2017-06-16 |
| Last Update Date | 2025-07-09 |