| NPI | 1336502863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2023-01859) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101266680) |
| 207R00000X Internal Medicine (Licence: NJ 25MA10823600) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2023-08-13 |