| NPI | 1922493857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2025-03264) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D91212) |
| 207R00000X Internal Medicine (Licence: MD D91212) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101275714) | |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2025-12-05 |