| 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 |