| NPI | 1114181203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 51027) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 103702) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2009-03-04 |