| NPI | 1811378235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA OP61670122) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 75083) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA OS022095) | |
| 207R00000X Internal Medicine (Licence: MI 5101021990) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2025-07-31 |