| NPI | 1235270927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60349184) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 104821) |
| 207R00000X Internal Medicine (Licence: OK 24986) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 53201) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2013-07-16 |