| NPI | 1003852047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 0426630) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA 042239-L) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 09769R) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2014-03-19 |