| NPI | 1932594314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 287372) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MN 68865) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2022-06-15 |