| NPI | 1639516206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 302611) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 75559) |
| 207R00000X Internal Medicine (Licence: MA 256140) | |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2023-11-07 |