| NPI | 1689611626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TN 2043) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 211797) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2014-05-30 |