| NPI | 1295738797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ID 0-122) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT MEDPHYSCOMLIC114155) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2024-01-02 |