| NPI | 1407135411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A177487) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.128500) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2022-08-22 |