| NPI | 1497957575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME134767) |
| Additional Taxonomies | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: AL 28127) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: FL ME134767) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2024-04-30 |