| NPI | 1801875646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 126015) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 039077) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2013-10-16 |