| NPI | 1336147560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00028950) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO CDRH.0000446) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2026-08-25 |