| NPI | 1356436489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 220716) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 220716) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2021-02-09 |