| NPI | 1215297106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2018-02743) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME125676) |
| 207R00000X Internal Medicine (Licence: FL TRN17323) | |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2023-01-24 |