| NPI | 1013302348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR DO203654) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA OP61629049) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2025-08-19 |