| NPI | 1366405540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME102914) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 16027) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 31923) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 15276) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2023-07-26 |