| NPI | 1619385606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OK 35025) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 35025) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2020-06-18 |