| NPI | 1124000310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 173774) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 173774) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2011-07-11 |