| NPI | 1811254121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 73616) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 68002) |
| 208M00000X Hospitalist (Licence: NY 280569) | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2021-09-30 |