| NPI | 1770797359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME147718) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 58958) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 13554) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01072350A) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2026-04-08 |