| NPI | 1265641187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 62847) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME143836) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-12 |