| NPI | 1275821050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL 135194) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 19053) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2021-05-20 |