| NPI | 1689633760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: AR C7528) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR C-7528) |
| 208600000X Surgery (Licence: AR C-7528) | |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2020-03-24 |