| 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 |