| NPI | 1457339053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 1923861) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 192386) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2019-07-19 |