| NPI | 1841612439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WA OP61131025) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: IL 036.141540) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2023-05-12 |