| NPI | 1609964154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM 89-141) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A43699) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-11-09 |