| NPI | 1871813675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 79155) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A118801) |
| 207R00000X Internal Medicine (Licence: MA Unknown) | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2025-09-10 |