| NPI | 1104897131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 110460) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 110460) |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2012-08-02 |