| NPI | 1285772582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IN 01079427B) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 20120) |
| 174400000X Specialist (Licence: OH 35-041367) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2017-10-31 |