| NPI | 1871565572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00045819) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AK 234456) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2025-11-20 |