| NPI | 1356503593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102206444) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 93564) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2025-02-19 |