| NPI | 1487741237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: AL 00014649) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MT 79267) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2023-11-13 |