| NPI | 1922039684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: ND 9025) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MN 45369) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2017-08-31 |