| NPI | 1033464888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 63187) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 24737) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2023-12-29 |