| NPI | 1063439982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2008-00811) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 48827) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-12-21 |