| NPI | 1023075983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 075543) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 19469) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2018-05-31 |