| NPI | 1609847326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 213123) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 213123) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2019-01-15 |