| NPI | 1760462295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 22431) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 18141) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME56810) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2022-08-05 |