| NPI | 1386750073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2004034161) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: KS 0431054) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2015-06-30 |