| NPI | 1407169113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 82627-20) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q4975) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME146942) | |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2024-09-03 |