| NPI | 1982607081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 185151) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL OS19237) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2026-06-30 |