| NPI | 1366855405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A149308) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 259536) |
| 207R00000X Internal Medicine (Licence: CA A149308) | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2024-04-26 |