| NPI | 1184614455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OR MD151230) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD151230) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: ME MD21774) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2023-10-03 |