| NPI | 1720468523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC LL38301) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-53265) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2024-12-02 |