| NPI | 1952698169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60685337) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.207161) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2022-08-11 |