| NPI | 1487636254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 190197) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 190197) |
| 207RI0008X Internal Medicine, Hepatology (Licence: NY 190197) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2015-05-20 |