| NPI | 1649699737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102204388) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102204388) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2020-07-29 |