| NPI | 1073582961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 25011) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 37588) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2019-05-28 |