| NPI | 1174566616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 241797) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 082855) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 082855) | |
| 207R00000X Internal Medicine (Licence: MA 241797) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2012-09-24 |