| NPI | 1548525645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 29263) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 29263) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2015-07-02 |