| NPI | 1184694309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA C128014) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 51320) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2021-11-18 |