| NPI | 1881637742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD00046034) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT MED-PHYS-LIC-81016) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2025-07-22 |