| NPI | 1669469193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 21941) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 21941) |
| 207RR0500X Internal Medicine, Rheumatology (Licence: WI 21941) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2017-12-18 |