| NPI | 1225262868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MD D0077809) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0077809) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2016-10-18 |