| NPI | 1649428574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: ME MD23388) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 250191) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NY 250191) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MN 62460) | |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2022-07-21 |