| NPI | 1073565511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 46849) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 234884) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NY 234884) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: CT 46849) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2018-09-26 |