| NPI | 1710545785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 345887) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 1020803) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2026-07-31 |