| NPI | 1235157017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 190910) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 190910) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2013-07-23 |