| NPI | 1063667608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2015-00861) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0060068) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 84983) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101268563) | |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2021-06-07 |