| NPI | 1205929841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0028739) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL OS5831) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2017-12-14 |