| NPI | 1285082628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD61322425) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61322425) |
| 207R00000X Internal Medicine (Licence: RI LP03699) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 58175) | |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2022-08-29 |