| NPI | 1952325599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME163668) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 239090) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2025-03-05 |