| NPI | 1386936110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC MD36765) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN15884) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 56417) | |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2024-05-13 |