| NPI | 1356376719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MA05187500) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35.143014) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2021-08-24 |