| NPI | 1386106003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 318769) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS22006) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL OS22006) | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2025-04-29 |