| NPI | 1275638165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G64180) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: CA G64180) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2019-11-27 |