| NPI | 1407952096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60544064) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX E4842) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WA TD60544072) | |
| 207R00000X Internal Medicine (Licence: WA MD60544064) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2016-02-09 |