| NPI | 1043281280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 155527) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NY 155527-1) |
| 174400000X Specialist (Licence: NY 155527-1) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2018-05-18 |