| NPI | 1841308384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00048377) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD29167) |
| 207R00000X Internal Medicine (Licence: WA MD00048377) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2012-06-28 |