| NPI | 1801962881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 1336291) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 1336291) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-04-29 |