| NPI | 1932549433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 89029) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD458254) |
| 207R00000X Internal Medicine (Licence: GA 89029) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2026-06-10 |