| NPI | 1023057445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 39675) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101055262) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME175128) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2026-08-27 |