| NPI | 1750725040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 283832) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 285151) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2020-09-22 |