| NPI | 1952807794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 1022248) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1022248) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2024-00553) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2025-09-23 |