| NPI | 1083665962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TN 43053) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: CT 044341) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2017-12-26 |