| NPI | 1639120124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 170329-1) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 170329) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2013-08-14 |