| NPI | 1710986898 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH EL10071) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 027392) | 
| Enumeration Date | 2005-07-20 | 
| Last Update Date | 2022-10-03 |