NPI | 1750544425 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 289446) |
Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD455644) |
Enumeration Date | 2008-07-03 |
Last Update Date | 2025-03-15 |