| NPI | 1366458309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD61175547) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 14186911-1235) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 46158) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2025-04-14 |