| NPI | 1477626810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 28634) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT 129419) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2024-08-27 |