| NPI | 1770825713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 11676583-1205) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60587041) |
| Enumeration Date | 2013-03-17 |
| Last Update Date | 2023-11-27 |