| NPI | 1295778215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA C-183205) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NM MD2022-1353) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: AZ 30038) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: KY C0072) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: WV 29905) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2023-11-08 |