| NPI | 1235229584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: VA 0101238376) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: GA 064648) |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2018-10-31 |