| NPI | 1952644346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60975309) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 66830-20) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2020-07-16 |