| NPI | 1912285644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AR E-10276) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301098346) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2017-05-19 |