| NPI | 1023127909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL me53996) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME53996) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-08-02 |