| NPI | 1528599008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA LA326897) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD470274) |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2024-08-30 |