| NPI | 1538615737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 76451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 62567) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2024-10-21 |