| NPI | 1114189495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G54492) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 47465) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2016-05-31 |