| NPI | 1932217544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A74259) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A74259) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2016-04-21 |