| NPI | 1023338654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA FE 60356665) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 56493) |
| Enumeration Date | 2010-06-05 |
| Last Update Date | 2016-06-27 |