| NPI | 1366527186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA MD00016612) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00016612) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00016612) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2010-12-29 |