| NPI | 1073595419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME140981) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 42486) |
| 208600000X Surgery (Licence: MA 42486) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2020-02-19 |