| NPI | 1043284227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 191465) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ MA64260) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2011-09-22 |