| NPI | 1881725836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 220745-1) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: ND 21916) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2025-02-05 |