| NPI | 1346406147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2009-02033) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY AT3436929) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2010-06-22 |