| NPI | 1760915771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 20A22252) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A22252) |
| 207R00000X Internal Medicine (Licence: TN 0000004580) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2024-10-08 |