| NPI | 1598717704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 172721) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 172721) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-10-11 |