| NPI | 1689968463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME154927) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 51934) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101253444) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2024-06-07 |