| NPI | 1063405900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA04025600) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 149677) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2018-08-13 |