| NPI | 1912357187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD192209) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61306864) |
| 207R00000X Internal Medicine (Licence: OR MD192209) | |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2023-11-30 |