| NPI | 1295742344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 33295) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: KY 33295) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2008-04-30 |