| NPI | 1013132000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX M6395) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME99678) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: DC MD034817) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-10-16 |