| NPI | 1053584631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 57392) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NV 15844) |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2015-09-10 |