| NPI | 1689781361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 21585) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101246947) |
| 207R00000X Internal Medicine (Licence: AZ 24657) | |
| 207R00000X Internal Medicine (Licence: CA A45944) | |
| 207R00000X Internal Medicine (Licence: WA MD60709322) | |
| 207R00000X Internal Medicine (Licence: KY C0140) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A45944) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60709322) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101246947) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 24657) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: KY C0140) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2024-11-07 |