| NPI | 1164521019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD20286) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0044035) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101270422) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-11-06 |