| NPI | 1801974076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60041838) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 42882-020) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2017-01-06 |