| NPI | 1215591110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 103685) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME156967) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2026-05-12 |