| NPI | 1659798650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD70015037) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A139679) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2026-05-29 |