| NPI | 1124054861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME177645) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 222863) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA08025600) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2026-04-09 |