| NPI | 1386036333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 05983) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 6004) |
| Enumeration Date | 2015-02-28 |
| Last Update Date | 2022-08-02 |