NPI | 1558749051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 308006) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT208803) |
Enumeration Date | 2015-05-15 |
Last Update Date | 2021-12-09 |