| NPI | 1063674596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2018011080) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 04-35016) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2018-08-03 |