| NPI | 1902083587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60270097) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 104295) |
| 207R00000X Internal Medicine (Licence: GA 002021) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 52138) | |
| Enumeration Date | 2008-01-26 |
| Last Update Date | 2021-03-31 |