| NPI | 1295759181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00042068) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD157354) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: ID M-14248) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2018-08-01 |