| NPI | 1043491830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25ma08477200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25ma08477200) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2015-09-23 |