| NPI | 1659332450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 37252) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 37252) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2020-04-14 |