| NPI | 1710942750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60272049) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 158885) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 158885) | |
| 207R00000X Internal Medicine (Licence: WA MD60272049) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2012-05-09 |