| NPI | 1720116924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: IN 01038295) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: KY 50053) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2023-07-11 |