| NPI | 1346464765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA C54497) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M7330) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2017-09-19 |