| NPI | 1295862134 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: VA 0101259771)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101259771)  | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101259771)  | |
| Enumeration Date | 2007-02-27 | 
| Last Update Date | 2024-02-01 |