| NPI | 1053608687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 69890) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301099393) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-45614) | |
| Enumeration Date | 2011-07-04 |
| Last Update Date | 2024-08-21 |