| NPI | 1639135007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WI 3916-320) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: WA MD00039787) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2024-03-13 |