| NPI | 1619178027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60197486) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NV 14761) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2024-09-26 |