| NPI | 1427031731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 20893) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME0069582) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 23952) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2016-02-18 |