| NPI | 1205857737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A72022) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60236713) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2026-07-22 |