| NPI | 1053630285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0083232) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD045930) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2025-02-06 |