| NPI | 1194763011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 124862) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 124862) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2021-06-10 |