| NPI | 1861995672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2022012616) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022012616) |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2026-08-13 |