| NPI | 1790725778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 184290) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 1.080961) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2025-06-03 |