| NPI | 1962505909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 165451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 165451) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2018-09-24 |