NPI | 1376057034 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 21551) |
Enumeration Date | 2017-11-16 |
Last Update Date | 2023-06-29 |