NPI | 1770544678 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 46148) |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: MN 46148) |
Enumeration Date | 2006-03-30 |
Last Update Date | 2023-11-06 |