| NPI | 1265637227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A123857) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R8077) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2013-10-01 |