| NPI | 1508023227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 54599) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: IA R-8255) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 105667) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2015-05-21 |