| NPI | 1407852353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME157995) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0067585) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD192722) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 200700105) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD425171) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 21764) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: ND 21216) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 350085209) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2025-06-17 |