| NPI | 1427443456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101261325) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101261325) |
| 208D00000X General Practice (Licence: VA 0101261325) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2021-06-30 |