| NPI | 1235422809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME119780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN16132) |
| 207R00000X Internal Medicine (Licence: FL ME119780) | |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2023-05-26 |