| NPI | 1598745002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 69824) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 33738) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 042-0014522) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-04-26 |