| NPI | 1194713131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101277286) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101277286) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2021-02420) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME132993) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 39503) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2023-03-02 |