| NPI | 1811197817 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 41016)  | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P8043)  | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01072912A)  | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301099885)  | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD432318)  | |
| Enumeration Date | 2007-07-19 | 
| Last Update Date | 2024-08-23 |