| NPI | 1215340674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME174469) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A154629) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A154629) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2025-08-18 |