| NPI | 1669664314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 045783) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 245703) |
| 207R00000X Internal Medicine (Licence: CT 045783) | |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2013-08-06 |