| NPI | 1235331943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: PR 17026) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 17026) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2011-11-21 |