| NPI | 1174851273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 71206) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 66136) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME135038) | |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2021-08-03 |