| NPI | 1467605139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA CFE39703) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: CA CFE39703) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |