| NPI | 1407167919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME120987) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 166723) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2024-11-08 |