| NPI | 1497022297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 73230) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 263043) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2023-03-05 |