| NPI | 1407810476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME132562) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 9400086) |
| 207R00000X Internal Medicine (Licence: NC 9400086) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2019-05-24 |