| NPI | 1841491321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 16955) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 16955) |
| 208D00000X General Practice (Licence: PR 16955) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2011-08-19 |