| NPI | 1275676843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD16753) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00034986) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-07-10 |