| NPI | 1285211243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 78938) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A192672) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2025-06-13 |