| NPI | 1093175325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL 19820) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 297567) |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2024-06-02 |