| NPI | 1518993229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: HI 16824) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: IL 036-121941) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2018-04-25 |