| NPI | 1235122011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 202780) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 95619) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2025-12-15 |