| NPI | 1144322801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 135601-1) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MA03842900) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2013-02-05 |