| NPI | 1760708002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME124576) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 164638) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2022-03-14 |