| NPI | 1023373172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: AZ 58050) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6733) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2019-11-14 |