| NPI | 1720114093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101287491) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A111638) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2025-11-13 |