| NPI | 1437599321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME127306) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME127306) |
| 207R00000X Internal Medicine (Licence: FL ME127306) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2024-04-21 |