| NPI | 1073522819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA OP00001803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB07250700) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MB07250700) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2008-09-03 |