| NPI | 1093896151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2011-00588) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 154491) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 079536) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2021-06-07 |