| NPI | 1922094580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101054566) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 103331) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2026-01-20 |