| NPI | 1578849519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 62492) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 003922) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2021-10-28 |