| NPI | 1740693605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 67373) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 304492-01) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2021-06-15 |