| NPI | 1053636829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME132755) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-120882) |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2020-08-19 |