| 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 |