| NPI | 1801869656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 46971) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 46971) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 104327) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2014-05-28 |