| NPI | 1043219819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60663353) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0060715) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2020-12-04 |