| NPI | 1720068315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME132426) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AR N7800) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-09-26 |