| NPI | 1942299821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME87117) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 47138) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2025-08-22 |