| NPI | 1528470135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ND 16735) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105686) |
| Enumeration Date | 2014-05-30 |
| Last Update Date | 2024-11-18 |