| NPI | 1124127048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301075826) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 228347) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2018-01-26 |