| NPI | 1831299254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 2OA7773) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 3602) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2016-08-16 |