| NPI | 1245665660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: ID O1109) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: ID O-1109) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2024-04-18 |