| NPI | 1851566095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 231371) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: NY 231371) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2016-07-20 |