| NPI | 1831552165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 299499) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 299499) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME160385) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2024-10-08 |