| NPI | 1265492730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME 654044) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 82518) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2023-10-19 |