| NPI | 1558593293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D84309) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q7445) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2022-03-09 |