| NPI | 1285022483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 301985) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO4223) |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2022-10-03 |