| NPI | 1912091794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME 89279) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD 425480) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2021-10-25 |