| NPI | 1760456677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME140883) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SD 5319) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2019-07-10 |