| NPI | 1972695765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 36606) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY C4622) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2025-11-26 |