| NPI | 1083723225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME141735) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: IN 01073888A) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NY 144389) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-02-27 |