| NPI | 1821720970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 94-11763) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022024456) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2025-07-01 |