| NPI | 1972130680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A205150) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 13284709-1205) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2026-07-06 |