| NPI | 1902850811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO CDRH.0031056) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT 118703) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2026-04-08 |