| NPI | 1497136840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME135075) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 263381) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2020-08-31 |