| NPI | 1538698253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: RI MD19208) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03977) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2023-07-31 |