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 |