| NPI | 1134161029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 11940) |
| Additional Taxonomies | 174400000X Specialist (Licence: WV 11940) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-03-07 |