| NPI | 1285668822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00042129) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD182143) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2025-02-25 |