| NPI | 1689803736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 265957) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A132741) |
| 207R00000X Internal Medicine (Licence: NY 265957) | |
| 207R00000X Internal Medicine (Licence: CT 054753) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: CT 054753) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: CA A132741) | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2017-06-06 |