| NPI | 1023384120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CT 76711) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MN 64471) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NY 274949) | |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2025-07-29 |