| NPI | 1093059925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2017-0029) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2017-0029) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2017-10-02 |