| NPI | 1023049434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX E7731) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX E7731) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-10-11 |