| NPI | 1932494739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 94030) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD61064472) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD182058) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 61879-20) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2026-05-21 |