| NPI | 1003263419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 04-46421) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2022037290) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2022-10-06 |