| NPI | 1700819422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA C54070) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA07458700) |
| 207R00000X Internal Medicine (Licence: PA MD426397) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0071310) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD426397) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2023-11-13 |