| NPI | 1265085039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 306536) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 65505) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2023-01-19 |