| NPI | 1346541380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A125264) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL33165) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2018-04-30 |