| NPI | 1942597018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME153405) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 263633) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2022-11-01 |