| NPI | 1689626103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 207025) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 207025) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2011-11-18 |