| NPI | 1205856887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 02160) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN D0762) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2023-08-02 |