| NPI | 1972568228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA 20A15726) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 167756-1) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OR DO213174) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2023-11-02 |