| NPI | 1205223351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME173479) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX s5478) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2025-07-01 |