| NPI | 1386687044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME126076) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 15952) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 15952) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2024-02-12 |