| NPI | 1972681500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60884533) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A90004) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-01-18 |