| NPI | 1295120061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101272213) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 209711) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-06-04 |