| NPI | 1346592912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 55954) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 106478) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2013-03-12 |