NPI | 1053316653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA049958) |
Additional Taxonomies | 173000000X Legal Medicine (Licence: NJ MA016100) |
Enumeration Date | 2005-06-20 |
Last Update Date | 2009-09-01 |