| NPI | 1760475024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 003658) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 3658) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2025-06-02 |