| NPI | 1649431511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 34619) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 53027) |
| 207R00000X Internal Medicine (Licence: NY 255638) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 53027) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 255638) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2024-02-01 |