| NPI | 1316068554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME140931) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 216259) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-02-12 |