| NPI | 1285602813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: VA 0101272036) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101272036) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MD D24240) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2023-11-21 |