| NPI | 1316920010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 38123) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00039076) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2008-08-28 |