| NPI | 1518088111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME 110297) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME 110297) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2022-12-21 |