| NPI | 1265703300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A122533) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA a122533) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 84078) | |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2021-03-23 |