| NPI | 1801010053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60647401) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E5097) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2019-06-21 |