| NPI | 1396727095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 40257) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 32905) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35130129) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2024-01-16 |