| NPI | 1386613206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A87308) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT 98403) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-03-21 |