| NPI | 1013165083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME142598) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2015-0529) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2024-06-12 |