| NPI | 1386608024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G46375) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G046375) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2020-01-21 |