| NPI | 1205941309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR CP206793) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY EMERGENT) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2023-02-22 |