| NPI | 1568434652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G308630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G308630) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2018-04-10 |