| NPI | 1215055140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A103886) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD159851) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2024-04-25 |