| NPI | 1255317285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME163485) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 41632) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2023-08-15 |