| NPI | 1376569673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 101430) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 0435695) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2017-11-08 |