| NPI | 1235535436 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 288883)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 288883)  | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA10384700)  | |
| Enumeration Date | 2014-11-15 | 
| Last Update Date | 2024-05-01 |