| NPI | 1225045396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 230437) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 040549) |
| 207R00000X Internal Medicine (Licence: CT 040549) | |
| 207R00000X Internal Medicine (Licence: NY 001982) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 001982) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2021-01-05 |