| NPI | 1679519797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME162947) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 42817) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2024-03-21 |