| NPI | 1699778019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME114343) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 138791) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2015-11-03 |