| NPI | 1932494739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OR MD182058) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-9295) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: WI 61879-20) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: WA MD61064472) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2023-04-25 |