| NPI | 1215966098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD MD46972) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD22644) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2019-08-28 |