| NPI | 1003309899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 327245) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04278) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-05-21 |