| NPI | 1497045173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 60201) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 60201) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2020-08-13 |