| NPI | 1245626670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09625700) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 295474) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2018-09-18 |