| NPI | 1609196179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 269060) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-244059) |
| 207R00000X Internal Medicine (Licence: NY 269060) | |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2021-10-12 |