| NPI | 1801940242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME138904) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 226165) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2019-01-29 |