| NPI | 1275982464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 12742773-1204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL1163) |
| 207R00000X Internal Medicine (Licence: NV DO2552) | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2022-06-20 |