| NPI | 1588794135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD160180) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: ID M-9783) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2013-06-27 |