| NPI | 1619926227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME15393) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME 15393) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2015-03-13 |