| NPI | 1285253104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 73560) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT221248) |
| 207R00000X Internal Medicine (Licence: PA student) | |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2023-10-17 |