| NPI | 1306062724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME 121905) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 058493) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2022-12-01 |