| NPI | 1982067799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME160374) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 291682) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2024-02-06 |