| NPI | 1013975564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME22208) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT 10734) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2012-08-16 |