| NPI | 1871976902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2023-03307) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: VA 0102207068) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2024-06-03 |