| NPI | 1194704106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA 37468) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT 50607) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2024-02-20 |