| NPI | 1992144844 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 71658) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6994) | 
| 207R00000X Internal Medicine (Licence: WI 71658) | |
| Enumeration Date | 2013-06-24 | 
| Last Update Date | 2025-09-04 |