| NPI | 1902347289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA OS023345) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 20A17428) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2025-07-29 |