| NPI | 1912989773 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD224189) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A45634) | 
| Enumeration Date | 2005-11-17 | 
| Last Update Date | 2025-04-24 |