| NPI | 1912928243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD21367) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D44486) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2010-07-01 |