| NPI | 1487687224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 1204) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G31103) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00041085) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-04-12 |