| NPI | 1376807206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 292517) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 292517) |
| 207R00000X Internal Medicine (Licence: MN 56760) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 56760) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2020-10-27 |