| NPI | 1609011287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2015-0453) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 003583) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 32961) | |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2023-09-22 |