| NPI | 1467746503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX s3684) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME136457) |
| 208000000X Pediatrics (Licence: MA 249023) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2023-08-03 |