| NPI | 1073870358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 72797) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 292949-1) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2022-08-17 |