| NPI | 1730349218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 255839) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 928900404) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2014-05-28 |