| NPI | 1194717819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OR MD150769) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00045686) |
| 207Q00000X Family Medicine (Licence: CA A88253) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2022-02-04 |