| NPI | 1487740296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 29020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00046051) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 44370) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2012-07-02 |