| NPI | 1730676610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2021-01944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC RTL18-0441) |
| 207R00000X Internal Medicine (Licence: NC 2021-01944) | |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2025-05-15 |