| NPI | 1154573830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME118032) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 27156r) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2018-04-19 |