| NPI | 1497013759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA A130298) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A130298) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2019-08-24 |