| NPI | 1780645564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 21649) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 21649) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2021-08-27 |