| NPI | 1528330313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D91786) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 274775) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 274775) | |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2021-06-10 |