| NPI | 1942239660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0048317) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2026-00945) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2026-03-20 |