| NPI | 1154859544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME145504) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 41137) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL 145504) | |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2024-06-09 |