| NPI | 1194952929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: RI MD13895) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 17056) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2020-10-02 |