| NPI | 1881803088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME142355) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0053090) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N8948) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2025-07-03 |