| NPI | 1902927353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 54327) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 233814) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 105592) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-11 |