| NPI | 1144454711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60595520) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 57680) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2025-01-14 |