Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 4301080488 | MI |
NPI | 1013039734 |
---|---|
Provider Name | Dr. Roberto Mauro Gamarra |
First Address | Farmington Hills, MI 48334-3230 |
Second Address | Farmington Hills, MI 48334-3230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 09/08/2010 |