| NPI | 1952342628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D83485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 158246-1) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D83485) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 158246-1) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2020-07-30 |