| NPI | 1588922520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 018778) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 18778) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2023-01-11 |