| NPI | 1265424550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 077618) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 155735) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2018-03-17 |