| NPI | 1285825463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60329062) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP1-0028946) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2020-05-21 |