| NPI | 1598921496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: SD 525) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 2255) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2023-02-14 |