| NPI | 1811017353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301084174) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301084174) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2023-10-11 |