| NPI | 1265432660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 147626) |
| Additional Taxonomies | 2080P0206X Pediatrics Pediatric Gastroenterology (Licence: NY 147626) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2007-07-08 |