| NPI | 1427043942 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD19652)  | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VT 0420010255)  | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 291445)  | |
| Enumeration Date | 2005-09-12 | 
| Last Update Date | 2024-01-23 |