| NPI | 1851375455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: HI MD-25477) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 42702) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2025-05-19 |