| NPI | 1619918109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 084541) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 084541) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-08 |