| NPI | 1518320399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2026-01841) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD477006) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME160920) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2026-04-17 |