| NPI | 1740427079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME106999) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 241889-1) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2021-03-02 |