| NPI | 1104263862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 64866) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 278550) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2022-01-19 |