| NPI | 1528422110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 62670) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 62670) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2020-08-05 |