| NPI | 1568618940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD035665) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D94311) |
| Enumeration Date | 2008-08-17 |
| Last Update Date | 2023-06-13 |