| NPI | 1811336092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 83124) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102203918) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2019-01260) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2025-01-28 |