| NPI | 1518288083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60342220) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60342220) |
| 207R00000X Internal Medicine (Licence: IL 125057410) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2022-01-18 |