| NPI | 1760833875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 71633) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7811) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2022-07-27 |