| NPI | 1356383889 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2012012460) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 0436448) | 
| Enumeration Date | 2006-06-11 | 
| Last Update Date | 2025-10-25 |