| NPI | 1528229267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 65079) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD036698) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2015-02-13 |