| NPI | 1356737332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 276165) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 300245) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0085897) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2021-09-13 |