| NPI | 1841283546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME148331) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 132622) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2024-01-10 |