| NPI | 1205923109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KS 04-38458) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2008009086) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-09-02 |