| NPI | 1780654145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 19139) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 19139) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2013-05-13 |