| NPI | 1013215078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 55647) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 77562) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2023-04-05 |