| NPI | 1740418466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 269244) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML60093599) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.129733) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: RI MD14911) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2017-03-03 |