| NPI | 1750300539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 1876521) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 1876521) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2026-01-15 |