| NPI | 1376860833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 273902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 260556) |
| 207R00000X Internal Medicine (Licence: NY 269145) | |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2018-04-17 |