| NPI | 1699719138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H4930) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H4930) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-04-08 |