| NPI | 1245643006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 50519) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL36945) |
| 207R00000X Internal Medicine (Licence: KY 50519) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2020-08-18 |