| NPI | 1083754147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OK 24505) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 24505) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2017-05-15 |