| NPI | 1942299771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 206560) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: HI MD-23726) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2025-11-11 |