| NPI | 1801029608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME130537) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.15805) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2024-05-13 |