| NPI | 1265928501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD61474274) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61474274) |
| 207R00000X Internal Medicine (Licence: PA MT216962) | |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2024-07-03 |