| NPI | 1912347360 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01089722A) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.127481) | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD047262) | |
| Enumeration Date | 2013-06-30 | 
| Last Update Date | 2023-03-23 |