| NPI | 1487094397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2021029587) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB10357800) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 5101027745) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2024-01-12 |