| NPI | 1760800403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME165532) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 1760800403) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2019-02564) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2024-02-05 |