| NPI | 1699117754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME151518) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 285330) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD467576) | |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2024-12-02 |