| NPI | 1215908819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD d0067403) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC md037959) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101245606) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2011-02-23 |