| NPI | 1497897771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60202111) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 76493) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2012-03-27 |