| NPI | 1598835860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0021833) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD11219) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2008-02-13 |