| NPI | 1144967191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 82316) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-54441) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2026-06-09 |