| NPI | 1952336059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G88388) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 16858) |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: OK 16858) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: OK 16858) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2016-01-22 |