| NPI | 1811987324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 34525) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 31836) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2007-07-13 |