| NPI | 1740473925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: LA 202172) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA PGY.1.EKL.IM) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2013-11-14 |