| NPI | 1447652672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 021511) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 21511) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2025-05-12 |