| NPI | 1205038197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0070891) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101248771) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD038871) | |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2021-06-02 |