| NPI | 1760694186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60198109) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2014-0212) |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2021-07-07 |