| NPI | 1295153690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101263469) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 291049) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 291049) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-12-02 |