| NPI | 1518976778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101244869) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0062709) |
| 207R00000X Internal Medicine (Licence: DC MD034717) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-06-14 |