| NPI | 1437130622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25689) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 101217) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2010-10-04 |