| NPI | 1477550572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00048558) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 43602) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2021-04-16 |