| NPI | 1831149566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: HI MD-20653) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME95163) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NJ MA45913) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2022-10-24 |