| NPI | 1851573570 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 13835) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 233430) | 
| Enumeration Date | 2007-12-04 | 
| Last Update Date | 2015-12-31 |