| NPI | 1689092801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD61168258) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D88881) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2021-09-23 |