| NPI | 1760758106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A141808) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE CA-A141808-A) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2025-02-04 |