| NPI | 1649539974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 294199) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 18196) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2018-07-02 |