| NPI | 1316930506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0046511) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G43123) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2017-03-23 |