| NPI | 1235236670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 015873) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 15873) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2010-07-28 |