| NPI | 1316388556 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MB10130600)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 6450)  | 
| 207R00000X Internal Medicine (Licence: VA 0102208235)  | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 6450)  | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102208235)  | |
| Enumeration Date | 2013-07-16 | 
| Last Update Date | 2025-10-16 |