| NPI | 1992776884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA OP60322613) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 02002013A) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2018-05-23 |