| NPI | 1487940714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA OP60471571) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: ID O0875) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2025-03-19 |