| NPI | 1558423921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 158446) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 158446) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2011-06-17 |