| NPI | 1790874055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 26274) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-30617) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 04-30617) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2013-02-18 |