| NPI | 1609898618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME115413) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 200279) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2013-05-16 |