| NPI | 1710963426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 203833) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 041827) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2013-10-16 |