| NPI | 1598299893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2019-02731) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-02731) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2023-05-11 |