| NPI | 1568449650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A110121) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 47712) |
| 207R00000X Internal Medicine (Licence: CA A110121) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2024-04-12 |