| NPI | 1114367869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD61274732) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-38964) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2022-09-21 |