| NPI | 1063894343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 0) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03519) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2021-05-04 |