| NPI | 1417930454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WA MD00045918) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME87335) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2020-12-08 |