| NPI | 1386848752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301091849) |
| Additional Taxonomies | 174400000X Specialist |
| 207R00000X Internal Medicine (Licence: IL 125-050265) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2021-08-04 |