| NPI | 1851683395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101272034) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NC 24082) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 24082) | |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2023-08-25 |