| NPI | 1811230147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD224469) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A132935) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2025-08-05 |