| NPI | 1801117528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 54205) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 60720) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2021-08-03 |