| NPI | 1013228964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: AZ R77497) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198274) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2022-06-11 |