| NPI | 1487944666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60919002) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 54323) |
| Enumeration Date | 2011-04-09 |
| Last Update Date | 2022-07-21 |