| NPI | 1255305520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NV 12053) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 44964) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2024-05-30 |