| NPI | 1487045696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 81693) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WI 86016952) |
| 207R00000X Internal Medicine (Licence: MN 30776) | |
| 207R00000X Internal Medicine (Licence: MN 69570) | |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2023-06-27 |