| NPI | 1285742882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX G6238) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX G6238) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2024-09-12 |