| NPI | 1710957360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD61224828) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD21164) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2022-02-03 |