| NPI | 1902845761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 189198 1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 189198 1) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2011-09-19 |