| NPI | 1346525128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102202970) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL OS14932) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 20A12467) | |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2020-05-28 |