| NPI | 1447287743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N8943) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 140658 1) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2012-03-09 |