| NPI | 1124034970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 43305) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 102372) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60071532) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 48998) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-09-03 |