| NPI | 1336151711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MD D0020447) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: DC MD9970) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2016-04-28 |