| NPI | 1477532398 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 45883) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 57391) | 
| Enumeration Date | 2006-01-10 | 
| Last Update Date | 2024-05-15 |