| NPI | 1003279761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL OS20018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101022515) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2023-07-31 |