| NPI | 1174811608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD219156) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60787977) |
| 207R00000X Internal Medicine (Licence: OR MD219156) | |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2024-07-24 |