| NPI | 1801281738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 292835) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101280697) |
| 207R00000X Internal Medicine (Licence: TN 70073) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101280697) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 70073) | |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2025-01-17 |