| NPI | 1831519495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 300638) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 300638) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME152899) | |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2022-03-08 |