| NPI | 1336403062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60246817) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301100064) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2020-07-01 |