| NPI | 1962721530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KY 49529) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125:057419) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: IL 125.057419) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: KY TP205) | |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2023-07-13 |