| NPI | 1205875952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: SC 34504) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 34504) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 151621-1) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-06-14 |