| NPI | 1326235623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: DE C1-0009726) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 390200000X) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2014-02-06 |