| NPI | 1548689409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 282420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10049996) |
| 207R00000X Internal Medicine (Licence: FL ME136246) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2020-07-17 |