| NPI | 1790901940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 0165007A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01065007A) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2025-03-19 |