| NPI | 1861870289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 61020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 61020) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 75415) | |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2021-08-12 |