| NPI | 1356907968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 042.0018490) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 335688) |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2025-07-22 |