| NPI | 1245472869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME106701) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 11185) |
| 207R00000X Internal Medicine (Licence: FL ME106701) | |
| 207R00000X Internal Medicine (Licence: NY 241399) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 241399) | |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2016-06-03 |