| NPI | 1265667778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MN 55599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 106408) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2021-05-17 |