| NPI | 1336122274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD186697) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60226463) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60226463) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2020-11-06 |