| NPI | 1396719894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA03630700) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MA03630700) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2018-06-16 |