| NPI | 1265816409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WV 31030) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MA10445200) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2023-08-09 |