| NPI | 1700833498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60027255) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 222765) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2012-11-16 |