| NPI | 1477560316 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 290318) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 37864) | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA09673200) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.098331) | |
| Enumeration Date | 2006-08-02 | 
| Last Update Date | 2025-09-29 |