| NPI | 1497065338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2016-00612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125058477) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2022-07-21 |