| NPI | 1831284165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME93782) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 32107) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G87680) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 168308) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-03-08 |