| NPI | 1114369279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 65223) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q8630) |
| 207R00000X Internal Medicine (Licence: MN 65223) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2021-09-02 |