| NPI | 1639350622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME113916) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2007015061) |
| Enumeration Date | 2007-11-18 |
| Last Update Date | 2014-07-10 |