| NPI | 1114370749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2024-00043) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25ma10613600) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2024-06-13 |