| NPI | 1417110982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 21798) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 27198) |
| Enumeration Date | 2008-07-05 |
| Last Update Date | 2014-08-28 |