| NPI | 1356325088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101052186) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA07051700) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2015-12-10 |