| NPI | 1669660379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WA MD60513782) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2005003970) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: AL MD32871) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2014-12-03 |