| NPI | 1063695591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 49200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 60 246893) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2014-10-14 |