| NPI | 1801025440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 48536) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01066536A) |
| Enumeration Date | 2009-07-03 |
| Last Update Date | 2012-06-07 |