| NPI | 1861841488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 70438-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.068981) |
| 207R00000X Internal Medicine (Licence: WI 70438-20) | |
| Enumeration Date | 2016-06-04 |
| Last Update Date | 2019-11-20 |