| NPI | 1881656783 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 26504) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 26504) | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD195941) | |
| Enumeration Date | 2006-04-05 | 
| Last Update Date | 2025-03-21 |