| NPI | 1942235288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A101486) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 024681) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2014-01-03 |