| NPI | 1982804472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 292817) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 43300) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2022-11-21 |