| NPI | 1902891625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 86784) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 19976) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2022-08-08 |