| NPI | 1154575892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60724633) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 71002) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2024-09-25 |