| NPI | 1174758429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 238408-1) |
| Additional Taxonomies | 174400000X Specialist (Licence: DC MD037983) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2011-02-02 |