| NPI | 1740535095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WA MD61154634) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NM MD2020-0291) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: AL 36762) | |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2023-08-01 |