| NPI | 1346213824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D44427) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NV 11447) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2010-03-09 |