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 |