NPI | 1619262110 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 55402) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 55402) |
Enumeration Date | 2011-06-13 |
Last Update Date | 2022-07-21 |