| NPI | 1649261256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ND 15083) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA C151266) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 44790) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2023-12-26 |