| NPI | 1871563569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MN 44761) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MN 447) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2020-08-18 |