| NPI | 1396090940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME115242) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A124874) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD459562) | |
| 207R00000X Internal Medicine (Licence: NY 271545) | |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2022-02-22 |