| NPI | 1104936855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME144512) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 054596) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2026-08-26 |