| NPI | 1801195565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 76586) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 269178) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD469399) | |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2024-02-21 |