| NPI | 1023095692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 005613) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 5613) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2012-11-08 |