| NPI | 1033105903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME142694) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA065097) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 51971) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2021-03-30 |