| NPI | 1912325044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 290208) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 259840) |
| Enumeration Date | 2014-04-05 |
| Last Update Date | 2022-04-13 |