| NPI | 1255625307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101282073) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D79842) |
| 207R00000X Internal Medicine (Licence: MA 257525) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 38487) | |
| 208M00000X Hospitalist (Licence: MD D79842) | |
| 208M00000X Hospitalist (Licence: MA 257525) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2024-09-12 |