| NPI | 1639589781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60742811) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S5134) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2024-02-19 |