| NPI | 1053705640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 2021-01753) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 289811) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2022-11-14 |