| NPI | 1083696298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 203754) |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: MA 203754) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2018-12-18 |