| NPI | 1174728679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA08789900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MP191261) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA08789900) | |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2024-04-09 |