| NPI | 1891174314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD61297064) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 60685) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2022-08-26 |