| NPI | 1821418120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 14260238-1205) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: ID M-15969) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.138552) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2026-03-17 |