| NPI | 1073834792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL md.35145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL32661) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2023-10-02 |