| NPI | 1427464130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 8317) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2014021930) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2018-10-19 |