| NPI | 1740462464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TN 64913) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: ND 13385) |
| 207R00000X Internal Medicine (Licence: VA 0101245692) | |
| 207R00000X Internal Medicine (Licence: CA A101582) | |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2024-08-09 |