| NPI | 1306068150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MN 54054) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD428755) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MN TP105344) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2023-03-07 |