| NPI | 1083144638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: RI MD17544) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD17544) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2024-04-11 |