| NPI | 1427382985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A111337) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116019729) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2020-12-18 |