| NPI | 1811351042 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 68559-20)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 68559)  | 
| Enumeration Date | 2016-04-13 | 
| Last Update Date | 2022-09-12 |