| NPI | 1225599418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME173474) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 11887209-1205) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-06-04 |