| NPI | 1114216876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CT 69307) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 279897) |
| 207R00000X Internal Medicine (Licence: NJ 25MA09513400) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD467605) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2024-08-01 |