| NPI | 1346553294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME151469) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 104936) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2022-02-18 |