| NPI | 1376585067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WI 81818) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: KY TP824) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NY 139083) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MI 4301510330) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2024-08-30 |