| NPI | 1912386806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 61196) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 26964) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 26964) | |
| Enumeration Date | 2015-05-25 |
| Last Update Date | 2022-07-13 |