| NPI | 1346691573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0116032506) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 32283) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2022-08-16 |