| NPI | 1083663330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 33381) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: KY 33381) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2024-05-15 |