| NPI | 1982812483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60858449) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AR E-7120) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2018-07-11 |