| NPI | 1184887432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KY 43526) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 43526) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2014-02-14 |