| NPI | 1609896596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 30250) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 04-31177) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: ND 11673) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2014-08-11 |