| NPI | 1184664807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0023008) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT MED-PHYS-LIC-78836) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2023-12-12 |