| NPI | 1487620563 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD27327) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60300293) | 
| Enumeration Date | 2006-02-27 | 
| Last Update Date | 2024-11-04 |