| NPI | 1063728665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KS 04-39153) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2018012224) |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2021-01-25 |