| NPI | 1831621929 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD191801) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD191801) | 
| Enumeration Date | 2017-03-29 | 
| Last Update Date | 2024-07-08 |