| NPI | 1235223512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 147889) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 042-0007616) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2018-12-21 |