| NPI | 1891928123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: PR 18735) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18735) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2016-07-06 |