| NPI | 1285951905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA A119400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A119400) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MT 127459) | |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2023-06-07 |