| NPI | 1003293622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 3417) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 30380) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2025-03-04 |