| NPI | 1982651857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 27577) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 27577) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2024-09-16 |