| NPI | 1982994018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 51289) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 51289) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2018-07-23 |