| NPI | 1841596152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 73304) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.201923) |
| Enumeration Date | 2011-02-03 |
| Last Update Date | 2025-08-08 |