| NPI | 1932106499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 147287) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: ND 10169) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2008-11-17 |