| NPI | 1811206246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 042.0015577) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AK 117168) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2024-08-20 |