| NPI | 1356336929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO MD R8C47) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 04-20022) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2009-12-16 |