| NPI | 1548266174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 110178) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: KS 26299) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2016-01-20 |