| NPI | 1285875484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 047422) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 047422) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2016-11-03 |