| NPI | 1083033765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME134227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL MFC1715) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2023-06-15 |