NPI | 1639195993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 195225-1) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 80757) |
Enumeration Date | 2006-07-13 |
Last Update Date | 2025-04-22 |