| NPI | 1144602780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 303393) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 303393) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2022-07-19 |