| NPI | 1972032258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD27979) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 81556) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2024-10-01 |