| NPI | 1841401031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD036652) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101247425) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A95008) | |
| Enumeration Date | 2007-05-27 |
| Last Update Date | 2019-01-17 |