| NPI | 1629084975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 236326) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: DE C10009383) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-02-25 |