| NPI | 1316325749 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 60658) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 60658) | 
| Enumeration Date | 2015-05-18 | 
| Last Update Date | 2023-02-01 |