| NPI | 1962685222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60295858) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A97376) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2013-06-18 |