| NPI | 1942707641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD61673798) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 66493) |
| 207R00000X Internal Medicine (Licence: MN 29581) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 66493) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036168992) | |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2025-09-24 |