| NPI | 1669420618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 47840) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME150716) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2023-01-12 |