| NPI | 1174610950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 4538580) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 7286) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2023-07-05 |