| NPI | 1265696553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60501812) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10031201) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2021-09-28 |