| NPI | 1942555909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MN 63920) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME123629) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2020-10-27 |