| NPI | 1598932774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA L#025770) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: LA L#025770) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2009-09-18 |