| NPI | 1255342598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KS 0424600) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2006005749) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-11-01 |