| NPI | 1396717229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SD 3502) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 02660) |
| Enumeration Date | 2006-02-04 |
| Last Update Date | 2011-10-25 |