| NPI | 1306959002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD14023) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00034690) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2007-07-08 |