| NPI | 1497284764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME162369) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 57.248770) |
| 207R00000X Internal Medicine (Licence: IA R-10864) | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2025-12-12 |