| NPI | 1730380676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 81994) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD430583) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2013-12-10 |