| NPI | 1194783654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME89579) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME89579) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-03-19 |