| NPI | 1295794105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 170817) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 170817) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2008-05-22 |