| NPI | 1740277748 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD304861) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD034861) | 
| Enumeration Date | 2005-10-04 | 
| Last Update Date | 2010-06-02 |