| NPI | 1346232097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME139797) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 40612) |
| 207R00000X Internal Medicine (Licence: NJ 40740) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2025-09-03 |