| NPI | 1497720510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301059059) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI G5059059) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-02-03 |