| NPI | 1437150364 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 35886) | 
| Additional Taxonomies | 174400000X Specialist (Licence: KS 04-31077) | 
| Enumeration Date | 2005-08-02 | 
| Last Update Date | 2019-07-03 |