| NPI | 1164426987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 153768) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 042.0018332) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2025-08-20 |