| NPI | 1801151907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 300378) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 29194) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2019-09-04 |