| NPI | 1013992528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 189770) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 189770) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-11-04 |