| NPI | 1649474214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD179881) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60714868) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2025-05-03 |