| NPI | 1902898562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 9900221) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 93611) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2025-02-12 |