| NPI | 1306839543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OR MD25943) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: WA MD61033900) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2023-12-06 |